Frequently Asked Questions About Sexuality

Dr. Clifford and Joyce Penner have compiled this helpful information to assist those needing answers to difficult, yet frequently asked questions about sex. These topics, and many more, are covered in detail within the pages of the Penner’s books and in their video series. Our hope is that this information will help you and your spouse maintain a lifetime of fulfilling and nurturing sexual experiences.

FAQ's

Guiding Principles for Sexual Activity in Marriage

Guiding Principles for Sexual Activity in Marriage

We are often asked questions regarding sexual activities that are okay for a married couple to engage in with each other only.

Since the Bible doesn’t give any specific direction for sex within marriage, we have created guidelines that we believe are scripturally based.

Guiding principles for right & wrong in marriage:

Is it loving?

Is it mutual?

Does it build intimacy?

Does it in any way distance you from God or violate any biblical principle?

Go with the most conservative spouse, allowing that one to take small steps toward comfort with that activity if it fits the above criteria.

Hum-Drum Sex Life

Years ago our sex life was filled with a sense of adventure and fun. Now it’s predictable and, for lack of a better word, dull. I’m disappointed we’ve let sex become such a low priority and settled for the hum-drum. What can we do to bring back the excitement?

Sex becomes “hum-drum” when we don’t allow enough time or invest thought or preparation. To add excitement, become deliberate about making a change in your sex life.

A good place to begin is to change the location and the setting or atmosphere of your sexual encounters. The location is the room or area of the house (or the place outside the house) where you get together sexually. The setting or atmosphere involves what you do with the location. For example, you can vary the lighting; you can reverse your position in the bed, putting your feet at the “head” end; you can put a comforter on the floor or by the fireplace, instead of having your sexual experience in bed.

It will add spark to your relationship if you and your spouse take turns choosing the place and creating the atmosphere. This provides newness and an element of surprise. One couple found new life after they decided they could have sex anywhere but in the bedroom.

Sometimes it takes some struggling together to come up with alternative locations that will provide the privacy both of you need. Another couple, with six children found a unique solution. Since the little ones awakened early in the morning, and the teenagers stayed up later than their parents at night, the couple found they were rarely getting together sexually. And when they were, their sexual routine took about three minutes. Sexual intrigue had left their relationship soon after their second child was born 16 years before.

Finding new locations and creating a new atmosphere took some creativity. They reorganized the project room and added a hide-a-bed. This provided an alternate location to the bedroom. The teenagers were enlisted as part of the plan. The parents told them that “Mom and Dad needed some special time together.” Together they worked out a plan. One night a week, after the little ones were asleep, the teenagers were limited to the family room, the kitchen and their own bedrooms so the parents would have privacy. On Saturday mornings, the older children took turns getting up with the younger children to allow an additional private time for the parents. The smiles on the teenager”s faces indicated they caught on. It was a wonderful example of parents modeling healthy sexuality!

When there are no children or other people in the home, any location in the house that is comfortable, free of distraction and private is an option for creating a new setting. A van or camper could serve the same purpose.

Changes in lighting can vary the atmosphere for sex. The variations might include: no light, candlelight, dim light, bright light. You might find the visual enjoyment of each other’s bodies is enhanced by varying the placement of a candle or lamp. Some couples’ sex life is so routine and predictable that even a change in the bedclothes–a new bedspread or satin sheets are refreshing changes. Some couples enjoy the smell of scented candles. Others enjoy the use of perfumes or colognes.

In addition to having fun experimenting with the setting, you can exercise your creativity in many other areas. Clothing can be varied. If you have tended to begin with your nightclothes on, crawl into bed some night and let your spouse discover you without clothes on. On the other hand, if you are a couple who sleep in the nude, you may find it much more arousing and add new intrigue to have to take clothes off.

Teases that do not carry a jab, put-down, or pick on a sensitive issue, add excitement. The tease has to be fun. If you are the usual pursuer, resisting your partner, in a fun way, is one type of teasing that can enhance for both. This is the message that says, “Come on and try to get me,” or “See if I’m available.”

Whatever variation you use–however crazy it might seem–if it creates lightness and laughter and does not have to lead to intercourse and never violates, you have a good start on keeping alive your total sexual expression with each other.

Making Time for Sex

We would both like to be together sexually more often than we are. But by the time we work all week, take our children to their various activities and fulfill our responsibilities at church, we have no energy left. Any suggestions?

How about scheduling sex? With the busy lives we all lead, it’s necessary to do some planning for time together. If we don’t, our marriage will get only the time “left-overs” – or no time at all.

Every other dimension of our time is scheduled. Even our eating is predictably scheduled. (And we don’t wait for our hunger to dictate when we eat.) Yet, we have difficulty imagining that our sexual appetite could be fulfilled by planning times to be together. Many couples fear that scheduling will take away the aura of romance or the “mystery” of sex. Yet, if sex isn’t happening spontaneously, you’re not experiencing romance or mystery anyway.

We recommend that couples schedule 15 minutes a day for face to face, non-erotic intimacy and an hour or two of private time once a week. This weekly time should be free of interruptions from the telephone, doorbell, children, work demands or friends. The purpose of this time is to connect. Typically a couple might bathe or shower together, share their feelings and thoughts with each other, read and/or pray, and hug and kiss each other’s bodies just for the sake of touching and being touched. There can be talking, touching, caressing and loving without demand for response, but with the option of sexual interest and arousal that may proceed to a total sexual experience if you both desire that.

There must be a commitment to your scheduled times together. If you have to cancel one of your shared appointments, confer with each other and reschedule it. Make your relationship a top priority, then relax and bring joy to one another.

You must keep the pilot light of your sexual relationship lit–even if you don’t have the time and energy to turn the flames up as high as you used to. But how do you do that?

Keep kissing, passionately, every day. Kissing is the barometer of the state of your sexual relationship and can be a deliberate part of your 15 minutes per day..

Keep open by sharing every day. In addition to your 15 minutes of daily general connection, plan regular times to talk about sex. Talk about what you like and don’t like. Share your dreams and desires. Negotiate your differences. Don’t give up.

Keep committed to sex, in spite of all the distractions. Your marriage and sexual relationship must continue to be high priorities. Be cautious of commitments that rob you of time for one another.

Keep physically fit. Rather than being on your cell phone, take a walk together or go bicycle riding. In fact, the best thing you can do for your sex life is to turn your cell phone off!

Keep well-groomed. Maintaining proper care of your body and practicing good hygiene show that you care about and respect your spouse.

Keep your sexual feelings turned toward home. Fantasize being with each other. If sexual feelings are triggered in response to someone other than your mate, immediately put your spouse in the picture and bring the spark home!

Keep sex positive. Your sexual times will be most satisfying if they are free of demand and anxiety and full of care, warmth, physical pleasure and fun.

Keep learning about your own body and your mate’s body. Read books on sexual enhancement out loud together. Experiment with new ideas.

Keep coming up with surprises to keep sex from becoming boring. Leave a love note on your spouse’s pillow, light a candle, bring breakfast to bed, prepare a special dinner, bring flowers, complete an over-due project, or in your way tell your spouse he/she is special to you.

Is Quickie Sex Okay?

Is it all that wrong to have a quick sexual encounter to satisfy one mate’s or the other’s sexual urges, and then later in the week have a more leisurely, mutually fulfilling experience? Or is a “quickie” always a selfish act on the part of the person who gains a greater degree of satisfaction from it?

Quickies are great if they are mutually satisfying–or at least agreeable to both parties-and are not the consistent menu for your sexual experiences. A quickie now and then is not necessarily selfish or negative. In fact, quickies may be natural if your hectic lifestyle doesn’t permit leisurely sex as often as you both desire, or if one of you is in the mood and the other is a willing participant. The freedom to express your needs can be mutual and edifying to your relationship.

However, if one spouse repeatedly asks for quickies, the other may experience less interest in sex over time. Then the first spouse may become anxious about the other’s decreased interest and pursue quick sex more often. That pattern can become a negative spiral downward.

The best scenario for maintaining quality, fulfilling sex through all the years of your marriage can occur when both spouses feel free to express their sexual desires without placing demand on the other. But if you suggest a quickie, your spouse should feel free to suggest an alternative without communicating a sense of duty or dread. For example, he or she could say, “You caught me off guard. My mind is far from sex right now. Would it work for you if we have a quickie after I’m done with what I’m working on right now? That’ll give me time to shift gears.” Or the spouse may want to suggest another time or activity that would help him or her get in the mood in order for the time to be more mutual.

A quickie that benefits one spouse will not become selfish if both partners express their true inner desires and respond with care for the other without violating their own feelings. And, of course, a long-term, mutually satisfying sexual relationship will include regular leisurely quality time to enjoy each other’s bodies.

Should We Strive to Achieve Simultaneous Orgasms?

We’ve been married three years and we’ve never had an orgasm at the same time. I always thought this was something most couples enjoyed, and it seems like it would be wonderful to experience it. Is it really all that important, or should we give up trying?

It really isn’t all that important. The myth that simultaneous orgasm is the epitome of sexual fulfillment is based on a number of false assumptions.

First, it assumes that two people get aroused and then respond at the same pace. That is highly unlikely. Second, it assumes that goal-oriented sex is more fulfilling than pleasure-oriented sex. On the contrary, goal-oriented sex can interfere with fulfillment by introducing demand, anxiety and often a feeling of failure, all of which hinder the body’s natural response mechanism.

Goal-oriented sex requires a wife to be orgasmic during intercourse, which is not the case for more than half of all sexually active women. It often assumes that she will only have one orgasm so she has to time that orgasm to occur when her husband is about to ejaculate. Women have the capacity to have more than one orgasm, and it’s more likely that a woman who pursues multiple orgasms may have one when her husband does. Even then it works best when it is simply allowed to happen rather than worked toward as a goal.

As one woman put it, “I wouldn’t want to orgasm when he does because then I would miss out on his.” Many couples prefer to enjoy each other’s orgasms. That way, you can double your pleasure.

Deciding on Birth Control

My wife and I can’t agree on what type of contraception to use. She wants me to use a condom and I want her to take birth control pills. We already tried some other methods like the diaphragm but found they intruded on our spontaneity. What should we do?

Choosing and using a birth control method that is acceptable to both spouses can be difficult. When you reach an impasse, try to get some objectivity into your decision-making process.

We can offer some suggestions. Separately, each of you could make a chart evaluating the various birth control methods according to safety, effectiveness, convenience and personal preference. You may need to do some research on each method to present an accurate picture. Various interactive tools are available on-line to help you in this process. The American Academy of Family Physicians’ website – www.familydoctor.org – offers helpful information on birth control options.

The Barrier Methods are condoms, contraceptive sponges, the diaphragm and the cervical cap. These are used with a vaginal spermicidal.

In gathering data about different types of hormonal contraceptive methods, it’s important to understand that the hormones are combined differently in different methods/pills, so that your wife may be able to find one that works for her. MANAGING CONTRACEPTIVE PILL PATIENTS,
Thirteenth Edition, by Richard P. Dickey, MD, PhD, available at www.emispub.com or at 1.800.225.0694, is a helpful resource for that process.

Two methods that you have not mentioned are a more permanent surgical method that would only be an option if you are certain you never want more children and some form of natural family planning.

Once you have each done your homework, compare your findings. Take turns listening to each other and clarifying what the other thinks and feels, so that you each feel heard. Often this process will lead you to some mutually acceptable options. Two of our resources – the second chapter in our book Sex Facts for the Family and the ninth chapter in Getting Your Sex Life Off to a Great Start – are designed to walk you through the process of choosing a birth control method that can work for both of you. After you go through your decision-making process, consult your health care provider to finalize your decision based on your medical history.

Reduced Sex Drive After Children

My wife and I have been married for 19 years. We have a solid marriage, but our sex life began to deteriorate after our second child was born. My wife has lost virtually all interest in sex and refuses to talk about it. Is it usual for a woman to lose interest in sex as she gets older?

No, it is not “usual” for women to lose interest in sex as they get older. Loss of interest is usually related to issues other than age. If, for example, your wife’s interest in sex had begun to diminish after your first child was born, we would suspect the effects of pregnancy and childbirth. Fatigue, body changes, 24-hour responsibility for a totally dependent infant and changes in self-image (“now I’m a mother, not a sexual partner”) could affect her interest level.

However, since the loss of desire started after the second child was born, we would first question some physical issues. Does your wife experience pain during intercourse caused by the birth of your second child? Has she had a complete hormonal evaluation including a free or bioavailable testosterone level? If free testosterone is low normal or below normal, she may need to have her physician order a 1% testosterone cream to be applied to the vulvar area daily.

We also wonder if your response to her dip in sexual desire has, in any way, exacerbated the problem. We find that when a husband is anxiously preoccupied with his wife’s lack of interest or seems to need her to want him sexually to feel good about himself, then her normal ebb and flow of sexual desire will spiral downward with his negative concern. It may be very difficult to rekindle the fires of passion when negative attention is fixed on what may be a normal “dip.”

If this is the case with you and your wife, you need to back away from any expectation for sex and your focus on her diminished sexual desire. Instead, focus on other critical dimensions of your relationship and affirm any flicker of sexuality in her. Take time to communicate, to really get to know your wife’s heartbeat. Take walks; enjoy being together. Slowly, over time (and yes, it may take a long time), the building of this nonsexual intimacy will lay the groundwork for a more fulfilling, less frustrating sex life for both of you.

Finding Privacy For Sex with Kids in the House

Our children are approaching middle-school age, which has made us begin to wonder: How can my wife and I continue an active sex life when our kids are old enough to know what’s going on?

We, as parents, have the idea that our children should not know that we have an ongoing sexual relationship. Indeed, children should be protected from exposure to sexual activity between their parents, as well as details about their parents’ sexual happenings. However, most children are comforted to know that their mom and dad are taking time to love each other.

With this in mind, we recommend that parents plan private times for themselves. One of the gifts that we parents can give our children is the gift of a marital relationship that is based on love (as well as on a fulfilling sex life). This is sensed by children and is a major source of security for them.

But how can parents do this? Since children can be both an interruption and an intrusion in a couple’s sexual relationship, here are ten guidelines that can help parents keep “turned on” to each other–even after their children are old enough to know what’s going on.

First, make certain your sexual experiences are satisfying. These experiences need to be free of demand and anxiety, and full of care, warmth, pleasure, fun and intimacy.

Second, take care of your bodies. This includes making sure you get adequate rest, exercise and nutrition, as well as good grooming and preparing your bodies for your sexual times together.

Third, keep your sexual feelings alive by being aware of and affirming your sexual thoughts and sensations. If those feelings get triggered in response to someone other than your spouse, then turn those thoughts to each other.

Fourth, schedule quality time to be together physically. This time must be free of interruption and free of demands. You can either schedule this time when your children are being cared for away from home, when they are sleeping, or when they are old enough to be self-sufficient and know they should not interrupt you (except for emergencies).

Fifth, learn to give and receive bodily pleasure for the sake of pleasure. Learn to delight in each other’s bodies. Arousal, release and sexual intercourse could be the result of this time, but works best when they are not your expectation. These times will be most enjoyable when you are free to connect through talking, touching, caressing and loving without a demand for response.

Sixth, give yourselves permission to take responsibility to pursue your own sexual pleasure, but not at the expense of your spouse. For example, when you communicate what it is that your body hungers rather than expect that your spouse will automatically know what you desire, the sexual experiences will flow more freely.

Seventh, plan special treats such as music, candlelight, a “love nest” in front of the fireplace, a fun snack or a night away at a motel. Plan for these special treats by preparing your minds, your feelings and your spirits for each other. Think special thoughts. Thank God for your time together. Do any preparation that is likely to enhance your sexual feelings for each other.

Eighth, set aside times for teaching and experimenting with each other. Show your spouse the kind of touch you like. Teach each other about your bodies. Experiment with kissing. These are good times to work on areas of your sexual relationship that might need some enhancement.

Ninth, schedule sex-talk times that are separate from your physical times together. Use these times to communicate with each other about your sexual relationship. What things would you like to change? What are you particularly enjoying? What would you like to increase?

Tenth, go for help when your sexual relationship is not satisfying; if it has demands, or if it is filled with anxiety. Dealing early with any problems that occur is the best way for a couple to avoid developing destructive habits.

Kids Barging into Parent's Bedroom

Boy are we ever embarrassed! Our two children, ages seven and four, came barging into our bedroom the other night and caught us making love. We didn’t know what to say or do, and now I’m afraid we’ve perverted them or something. How should we have handled this?

To prevent something like this from happening again, we recommend putting a lock on your bedroom door and using it every time you are going to engage in any type of love play. But since your children did walk in on your lovemaking activity, it would have been most appropriate to have asked them to leave. Then, when you got yourselves presentable, you could have gone out and had a talk with them.

You could have explained that what the two of you were doing was loving each other sexually–a time of pleasure for both of you designed by God for marriage. But it is private, so it probably made them and you uncomfortable.

Allow them to talk about their feelings and ask any questions they might have. If this type of exposure is handled with care and openness, damage is not likely to result.

To avoid further embarrassment, however, you need to remember to lock your door whenever you’re enjoying sexual activity. It’s also a good rule for your kids to learn to always knock before they enter.

Positions for (Wife's) Maximum Pleasure

My wife and I have experimented with different positions during sex, and it’s important to me that she receive maximum pleasure from our times of intimacy. Is there one position that provides the best stimulation for women?

The process of enjoying each other sexually is not stagnant, but continually flowing and changing. So it’s good that you are trying different positions. It sounds as if you and your wife have the freedom to experiment and enjoy each other, but you just want to maximize enjoyment, especially for your wife.

Ultimately, your wife will be the best authority on what is most pleasurable for her. You might begin by doing some further experimentation to gather data about where your wife experiences the most genital sensation. (For diagrams and specific instructions, see pp 179-183 and 190-191 in Restoring the Pleasure.) After discovering where your wife feels the most sensation, you can then adjust positions during intercourse to maximize stimulation of those areas.

Traditionally, the husband has assumed the position on top of his wife. In that position, the Realignment Technique maximizes enjoyment for a woman by allowing the most contact with her total genital area, especially her clitoris. Basically, this technique involves the husband lying flat and sliding up toward his wife’s head. When using the woman-on-top position, the wife can vary the position of her legs and the angle of her body to get the most sensation.

If you find that your wife is particularly responsive in the G-spot area (the area just beyond the inner edge of the vaginal muscle on the upper side of her body), there are two positions that will put the penis at an angle to exert pressure on that area during intercourse. One is entry into the vagina from behind; the other is for her to be on her back with her buttocks at the edge of the bed and her legs on your shoulders and you standing or kneeling beside the bed, entering with your penis at an upward angle.

Sixty percent or more of women do not experience orgasm during intercourse. If your wife desires orgasm during intercourse, experimenting with positions can help enhance that possibility as long as that goal does not distract the two of you from the pleasure of just enjoying each other’s bodies.

It’s most important for you to develop an attitude of openness and freedom that is mutually comfortable. Don’t push your wife into a goal of trying new positions to enhance her pleasure. If she’s happy, let her be the authority on what she desires for her own sexual pleasure.

Inhibited About Appearance

My wife is extremely private about her body. Even though we’ve been married for several years, she still won’t change clothes in front of me. What can I do to help her feel more relaxed about her body?

There are several things you can do to help your wife feel better about her body. First, plan a time to talk with your wife about her feelings regarding her body and her reluctance to share herself with you. This discussion should take place apart from a time of sexual involvement or nudity. Let your wife know your reason for bringing up the subject is not to pressure her to change, but to help you understand her and to meet her needs better. It is important that she not feel judged for her modesty; she needs to experience your genuine care for her and your acceptance of her feelings.

Sometimes when a woman is hesitant to share her body, the husband himself is the problem. A wife may discover early in her marriage that exposing her body will inevitably lead to intercourse. If you responded to your wife this way, she may have felt like a sexual object, rather than feeling valued as a person. For her to feel safe enough to share her body with you, she will need to experience ongoing emotional closeness with you and a secure agreement that nudity will no longer equate sex.

Work to develop nonsexual intimacy by setting aside time each day for sharing feelings with each other and for doing activities together. Build daily affirmation into your lives with compliments, hugs and kisses that don’t lead to sex. And on a weekly basis, find more significant blocks of time for building this same kind of nonsexual intimacy and enjoyment.

Another factor that affects a woman’s modesty is how nudity was handled in her family. If your wife’s family was either extremely modest or inappropriate in exposure, she may have learned that it is not safe to share herself, even with you. When we have been raised with a high view of our bodies and with clear boundaries to protect them, we can freely give our bodies to our spouses. But if your wife didn’t grow up in such an atmosphere, your expectation of her to share her body will only cause more violation and decreased openness. Instead of making demands on her, provide safety in your relationship so your wife can gradually learn to share her body with you–at her pace and on her terms. The two of you may need professional guidance with this opening-up process.

How a woman perceives and accepts her body will also affect her sense of freedom to share her body with her husband. The view we have of our bodies–our body image–was formulated during our growing up years by the way we were held as infants and children, the messages we received from significant others about our bodies, and the models we looked up to and now measure ourselves against. The wider the gap between how we view ourselves and our image of the ideal body, the bigger our body-image problem. The goal is to narrow that gap by enhancing our view of ourselves and/or changing our ideal.

If you discover your wife struggles with her body image, you can help her by conveying your positive view of her through your touch and through verbal affirmation without sexual expectation. In addition, there may be efforts she could take to improve her view of her body. Sometimes exercise or weight-loss programs make a difference, but these must be her ideas, not your agenda for her.

It may also be important for your wife to adjust her image of the ideal body. Many women try to measure up to media personalities. To define beauty on that basis is unrealistic. When struggling with body image, it is important to remember God’s message: He looks on the heart; man looks on the outward appearance. Both are important but since God accepts her as the beautiful woman he made her to be and you are the man looking on the outside, you can help affirm that perspective.

Adapting to Body Disfigurement

My wife recently had a mastectomy due to breast cancer. I’m overjoyed that she will recover, and I want her to know how much I still desire and appreciate her body. But I’m not sure how to handle the loss of one of her breasts. For example, is that area still sensitive, or will it bother her if I try to stimulate her there?

Grieving the loss of a breast is a process that will take time for both of you. If your wife’s grief is still too fresh, she may not be able to talk about the loss yet. Let her know you want to talk whenever she is ready. Then just hold her, listen to her and tell her you’re available whenever and in whatever way she needs you.

Once she is ready to talk about and re-establish bodily enjoyment between you, you’ll be able to talk about your concerns. Set up a time to talk about her physical sensation. Let her know you are uncertain about how she would like you to bring her pleasure since the mastectomy. It will probably make her feel good to know you still desire her body and want to know if you should try to stimulate the area of the removed breast. Ask her how she is feeling and what is comfortable for her.

The physical sensitivity of that area will depend on the type of mastectomy–that is, which portion of the breast was removed. The scar tissue may be painfully sensitive to touch for a while. It is unlikely your wife will feel exactly the same sexual sensations as she did before surgery. Usually the nervous system’s receptors to sexual stimulation are severed in the process of the breast removal. Your wife is the only person who can tell you if it would bother her for you to try to stimulate her there. For some women, their husband’s interest in stimulating the area of the removed breast would be an incredible message of acceptance and affirmation. For others, it would be a violation or would distract from receiving sexual pleasure in other areas of their bodies. Both of you might find more pleasure by focusing on the remaining breast rather than on thearea of removal.

Your reconnecting process can be a time to establish an even more satisfying sexual relationship. Our society often associates a women’s sexuality with her breasts, and there are some valid reasons for this connection. The breasts are receptors of and responders to sexual stimulation. Nevertheless, it’s extremely limiting to focus exclusively on the breasts and genitals for sexual enjoyment. Sexuality involves body, soul, spirit and emotions. Allof our skin is responsive to touch. When we limit ourselves to certain parts of the body, we shortchange ourselves of all the potential for sexual pleasure available to us.

Any bodily disfigurement can interrupt or impair our ability to open ourselves to each other sexually. When we feel negative about our bodies, we may feel unworthy to give and receive sexual pleasure. If your wife suffers negative feelings about her body since her mastectomy, she may need a great deal of affirmation from you before she can risk sexual intimacy. Your and your wife’s ability to genuinely accept her physical change and maintain a sense of security in your relationship will be essential to ongoing sexual intimacy.

Turned Off By Weight Gain

After my wife had our third child, she didn’t lose the weight she had gained during the pregnancy. She seems to have given up the fight, and I’m having trouble seeing her as a desirable sexual partner. Whenever I try to discuss this situation, she doesn’t want to talk about her weight. What should I do?

This is a tough issue. Your wife’s excess weight is something only she can change, yet you are being affected by it. Talking to her about her weight like you have in the past won’t help. In fact, it could make her feel worse about herself and cause her to eat more.

Instead, the two of you might begin by deciding to see a counselor. You might meet with the counselor to discuss how your wife’s weight affects you. The same counselor could meet with your wife to understand her feelings about her excess weight and about your reaction to her appearance. Then the two of you could meet together with the counselor. The counselor would help make sure both of you feel heard and understood, and help implement steps toward change.

It’s possible that your wife would like to lose weight but has felt helpless. A counselor could connect her with a supportive program that focuses on reasons for eating, healthy eating, and exercise. You can help, too. Often husbands want their wives to lose weight, but they aren’t willing to stop buying and eating the offending foods. Your whole family must develop healthy eating habits if weight control is going to be an achievable long-term goal for your wife.

Whether or not your wife chooses to work on eating and exercise habits, you must begin to focus on her positive qualities. Affirming your love for her in spite of her weight is crucial. Some people use their weight to test the love of significant people in their lives. This especially happens to women whose parents were conditional in the way they gave and received love. It might be helpful for you to create a list of your wife’s positive attributes, and keep adding to it. Then regularly mention the things you value in her.

Sexually, change your focus from a visual response to her body to focusing on the sensation of skin-to-skin contact. Enjoy kissing. Enjoy her touch of your body. Enjoy looking into her eyes. Enjoy touching parts of her body that don’t trigger your reaction to her weight. Also, take over more of the household duties to give your wife additional time to take care of her appearance.

Body image is an issue that affects a person’s sexuality. How we feel about our bodies determines how readily and openly we are able to share them with our spouses. How we feel about a spouse’s body influences our desire for and response to him/her sexually. When there is a gap between how we view ourselves or our spouse and what we accept as an ideal body, we develop a body-image problem. To reverse that problem, we need to bring the actual and the ideal closer together.

Most people have unrealistic ideals about weight and beauty because television and movie personalities have become the standard. Of course, these people have the help of professional makeup artists, video enhancement and sometimes even a plastic surgeon. So consider whether your image of the ideal body is realistic and adjust it accordingly. Other times, a person’s body needs to be changed to fit more closely with a realistic view of the body. In your wife’s case, that could involve an eating and exercise plan. Both of you can enjoy your sexual relationship more fully as the real body and the ideal body become more similar.

Facing a Hysterectomy

My wife, who is only 43, just learned she needs a hysterectomy. What can I do to be supportive of her and reaffirm her sexuality? I’m also wondering if a hysterectomy will adversely affect our sex life. I’m not sure what to expect.

A hysterectomy is a major surgical procedure as well as a life change for your wife and, indirectly, for you. It is one of the safer surgeries, and many women find the quality of their lives improve afterward. We recommend you take several steps to prepare yourselves before your wife’s hysterectomy.

First, make certain the hysterectomy is necessary. Some medical authorities believe that some of the hysterectomies performed are unnecessary, so seek a second medical opinion. Also, get as much information as you can–from other women who have had hysterectomies and from reading. One source would be Dr. Joe S. McIlhaney’s book 1250 Health Care Questions Women Ask (Focus on the Family). McIlhaney addresses the issues of necessary and unnecessary hysterectomies.

Second, take charge of other factors that will affect your wife’s recovery and sex life after her hysterectomy. Before the surgery, she should get herself in as good physical condition as possible. Afterward, she should explicitly follow her doctor’s instructions for recovery. Support her in taking time to get back on her feet, and be certain she does no lifting and does not have sexual intercourse until her doctor approves these activities.

Third, the two of you should discuss with her physician what other surgical procedures will be involved. Will her ovaries need to be removed? Even though the ovaries decrease in their production of estrogen and progesterone as a woman goes through menopause, they excrete small amounts of testosterone until a woman is in her eighties. Since testosterone stimulates sexual desire, some women’s sex drive may lessen noticeably when the ovaries are removed. Even so, if there is a history of ovarian cancer in your wife’s family, keeping her ovaries may not be recommended.

Will she need a cystocele repair for a sagging bladder? If your wife is responsive sexually to G-spot stimulation (stimulation of the front wall of the vagina just beyond the inner ridge of the P.C. muscle–the muscle that controls the opening and closing of the vagina), surgery for a cystocele repair may interfere with that source of stimulation.

Another question to ask is if your wife will be on hormonal replacement therapy after her surgery. If she has not started menopause and will be keeping her ovaries, hormonal replacement therapy is unlikely. However, if she has started menopause or her ovaries will be removed, hormonal replacement therapy (estrogen and testosterone) started immediately will maintain her sexual desire and enhance her sexual experiences after surgery.

Fourth, know your wife’s sexual response now. Some women are very aware of the sensations of the uterine contractions that occur when they experience orgasm. These women have to shift the focus of their sexual sensations after a hysterectomy from the uterine contractions to the vaginal contractions. The vagina is not affected by a hysterectomy so the sensations of the penis in the vagina will not be disturbed, nor will vaginal lubrication be affected.

All these issues must be addressed to ascertain how your wife’s sexual experience will be affected and what your role needs to be as you support her. In general, more women find their sexual experience is improved after a hysterectomy than those who find it is negatively affected because they simply feel so much better. You can be supportive in gathering data, making decisions, giving your wife time to recover adequately, and positively participating in any new sexual discoveries and adjustments that become necessary.

Guarding Against Lust

How can I guard against sexual lust when I am traveling on business? It is at these times–when I’m alone and in an unfamiliar city–that I find myself surrounded by pornographic magazines at airport newsstands and by X-rated movies on television in my hotel room. Can you give me some suggestions on ways I can resist the temptation to indulge in these readily available magazines and movies?

We are created in the image of God, so we are created to be in relationship with God and with each other. That means that the sexual relationship between a human couple is more than just the physical act that we see animals engage in.

As humans, we have the capacity to think, to verbalize and to have mental pictures or images. These mental images may include fantasies in which we picture sexual activities. It’s not the fact that we have these images, but the content of these mental images that can cause us to violate God’s standard for us.

The Bible teaches that we are not tolust after something that is not ours. It also teaches that what we put into our minds influences who we become. Jesus said that if a man even looks at a woman (other than his wife) with the intent to be with her sexually, he has committed adultery. We do not understand that to mean that a man will never find other women attractive. Rather, we are to limit how we respond to those natural attractions by controlling both our thoughts and our actions.

Yes, it’s true that our world bombards us with sexual images. But it is our choice whether to pursue these images or resist them. We can choose not to turn on the X-rated movie in the hotel room. And we can choose not to look at the pornographic magazines at the airport newsstand. If a person doesn’t have control over those behaviors, then he has a sexual addiction.

So how can we keep our mental life pure? First, we fill our sexual thoughts with creative pictures of sexual activity with our spouse. Then wekeep our sexual relationship with our spouse alive. Further, we deliberately avoid the sexually explicit material of the newsstand or the television. Instead, we read healthy sexual material with our mate. And we make ourselves accountable to someone if we aren’t able to control the situation by ourselves.

None of these things is easy. They all take discipline. But they are essential if we are to maintain a pure thought life and a healthy, fulfilling sex life with our mate.

Re-establishing a Love Life After an Affair

My husband was involved in an affair. We have worked through some of our problems, and I believe he now intends to be faithful. But the memory of his affair freezes me up whenever we try to make love. I can’t help but wonder if he’s thinking about this other woman, and if he would secretly rather be with her. What can we do to get our love life back on track?

It sounds like you have worked through the initial shock and feelings of betrayal, rejection and anger. You also seem to trust your husband to be faithful. What you are struggling with is the long-term process of letting go and rebuilding confidence.

Communicate your concerns to your husband. Approach the subject when you are well-rested and free of distractions, and when you’re not involved in physical intimacy. Let your husband know that you are having difficulty freely giving yourself sexually and are worrying about his thoughts and preferences during sex.

Getting back on track sexually will require a rebuilding process. To do this, you might decide not to have intercourse until you feel ready to give yourself freely. Make a fresh commitment to each other, and start your sexual relationship as if it were new. Read our book The Way to Love Your Wife out loud together, especially the chapters on affair-proofing your marriage and bringing erotic adventure into marriage. If you need step-by-step guidelines, our book Restoring the Pleasure contains a self-help section for this very purpose. In addition to these sexual retraining assignments, work on finding ways of communicating when you are sexual that allow you to share your concerns as they surface and assure that your husband is actively engaged and keeping his mind exclusively on you. Plan ways to use nonverbal signals when you are being distracted by thoughts related to the affair. At that point get active in enjoying each other’s body and talking to each other about your enjoyment. This will help keep the two of you feeling connected.

Disturbing Sexual Requests

My husband wants us to engage in disturbing sexual ‘tricks.” For instance, he asks me to describe perverted situations, such as having intercourse with other women. Sometimes he looks at pornography during lovemaking. It’s true that these things accelerate my orgasm, but I can’t stand having a sex life that is so separate from my spiritual life. What should I do?

You are right in thinking a couple should integrate their sexual and spiritual lives. But to achieve that goal, you may need to practice “tough love.”Your husband’s use of pornography and illicit fantasy is completely inappropriate. It is unhealthy for you to engage in sexual talk that describes abuse, violates biblical standards or violates you.

If your husband is not willing or able to recognize the negative impact of his desire for these sexual “tricks,” as you call them, you should seek professional help. It is possible that he is struggling with a sexual addition, which counteracts intimacy. The more a couple uses outside stimuli to enhance their responsiveness, the less they will enjoy and respond to each other, and the more perverted the stimulus must be to continue to produce the same intensity of response.

Faulty thinking is part of a sexual addiction. Both you and your husband have believed your husband’s faulty thinking. A counselor can provide support as you refuse – lovingly, but firmly – to participate in his addiction. Your husband will need help to accept that his need is destructive and must be stopped. The best resource is a 12-step program designed for sexual addicts. Many of them can be contacted through the Internet. A good listing of sexual addiction recovery sites can be found at http://www.sarr.org. It provides links to many different groups, and information on how to locate or contact support/recovery groups near you. Among those which can be reached by phone are: Sexaholics Anonymous, 615-331-6230; Sex and Love Addicts Anonymous, 617-332-1845; Codependents of Sexual Addicts, 612-537-6904; and Sexual Recovery Anonymous, 212-340-4650.

Your question also makes us wonder why you have been reluctant to stand up to your husband. Sometimes victimization in a person’s background can confuse issues of sexuality. Perhaps you questioned whether your husband’s requests were valid. Perhaps you have allowed the abuse to continue because these practices did enhance your orgasm. Distorted sexual scenarios can be arousing for some people, especially for those who have been physically or sexually abused in the past.

It’s important to try to shift your husband’s need for outside sexual stimulation away from abusive or distorted scenarios and toward wholesome fantasies. Talking during sex can draw you together and distract you from thoughts that get in the way of your body’s natural sexual response. However, the content of your sexual talk must be consistent with biblical teaching and respectful of one another. Picturing the two of you in some exciting, romantic location or describing how different types of touching excites each of you will contribute in a healthy way to your sexual activity.

Your husband may not know how to find sexual fulfillment by connecting with you physically. The Song of Solomon is a beautiful model of erotic sexual expression between a husband and wife that grows out of a couple delighting in each other. The two of you might read it together in a modern translation and use it as the standard for expressing yourselves sexually in your marriage. You will have a great time and honor God as you do.

Anal Sex

Do you think it is acceptable for a husband and wife to engage in anal sex?

Anal sex is a practice that typically causes conflict between husbands and wives, is thought of as what the Bible condemns as sodomy (although many believe that sodomy is a reference to homosexual anal sex only), and tends to be initiated and desired by men whose interest got sparked by pornography. Many sexual experts and medical personnel discourage anal sex because of the danger of transmission of infection and tearing of the blood vessels in the rectum.

The penis and the vagina are clean passages, which are free of disease producing microorganisms. The anus/rectum, on the other hand, is a highly contaminated passageway. When the penis enters the rectum, the urinary and reproductive tracks of the man are invaded with the germs from the rectum of the woman. If the man enters the woman’s vagina after having entered her rectum, her reproductive passageways are then contaminated. Both can incur chronic infections like prostatitis, vaginitis or a pelvic inflammatory condition. But you might ask, what if we use a condom? The fact is condoms have a significant failure rate when used to prevent pregnancy, yet sperm are much larger than the microorganisms that infect. In addition, a woman can only be impregnated several days per month, but men and women can acquire an infection at any moment of the month. So condoms are not a sure protection against being infected especially when entering the tight muscle of the rectum.

The muscular structure of the anus is different than that of the vagina. The vaginal passageway is controlled by muscles, that expand or tighten to fit any size penis; the vagina is an organ of accommodation. The vagina can tighten so tight as to not allow anything to enter and can expand to allow the birth of an infant. The rectum cannot. That is why the blood vessels in the rectum break when the penis enters it causing damage to the anal/rectal area and raising the possibility of transfer of disease producing microorganisms.

Spiritually, we would interpret anal sex as not fulfilling the New Testament expectation of mutuality. According to I Corinthians 7 and other passages, husbands and wives are to equally give themselves to each other and to delight in each other’s bodies, but never is that to be one-sided or to violate or do something against the other or to be demanded. The husband is to love his wife as Christ loved the church (Ephesians 5), which required him to give up his rights like Christ did (Philippians 2) and give himself to his wife and love her exactly as she is. The women we talk to (in person, via e-mail, or through surveys at seminars) are hesitant or feel violated by their husbands’ pursuit of anal intercourse. Even in marriages where the men say their wives enjoy it, the women will tell us on the side that they do not.

Our personal/professional/spiritual stance on anal sex based on what we know today is that we would not recommend it. We will continue to study this issue and seek clear Biblical and physiological understanding.

Uncomfortable with Oral Sex

I’m extremely uncomfortable with the idea of oral sex, but my husband is disappointed that I won’t experiment with him. Am I wrong to feel this way, or should he accommodate my feelings?

Oral sex often causes conflict between spouses. This is a personal, highly controversial issue and can ultimately be resolved only between you and your husband. Some further information may help you discuss your beliefs and feelings about oral sex.

The three most common questions about oral-genital stimulation are: Is it morally wrong, is it “dirty” and is it unnatural? The Bible doesn’t give specific instructions about lovemaking activities within marriage. Thus we look for other scriptural principles. The principle that the husband is to love his wife as Christ loved the church and gave himself for her reinforces your desire for your husband to accommodate your feelings. On the other hand, the principle that we are to give our bodies to each other for our spouse’s enjoyment would encourage you to examine and stretch your own inhibitions (1 Cor. 7:3-5). In the Song of Solomon, the lover continually refers to enjoying the delights of his wife’s body–and she is equally enthusiastic about his. The lovers refer to tasting, eating and drinking of each other’s body (see Song of Solomon 4:4, 16 and 5:1).

Your discomfort may have to do with concerns about cleanliness rather than what is morally right. The anus is contaminated with disease-producing microorganisms in both men and women. If the genital area is contaminated from the anal area, the genitals are “dirty.” But when freshly washed and free of infection, the genital areas of both men and women are clean.

Perhaps your upbringing left you with the sense that oral-genital stimulation simply isn’t natural. If you feel violated by it, do not engage in it. Even though your husband may be disappointed, it does not violate him to forego that pleasure. The sexual act between a husband and wife is to be mutually enjoyable for both and never a violation of either. Since oral sex is uncomfortable for you, it will be best if you lead in any pursuit of oral sex.

Is Masturbation Wrong?

It seems to me that most husbands want intercourse more often than their wives do. My husband and I have a pretty regular sex life, but he occasionally resorts to masturbation when we’ve been apart due to illness, business travel or whatever. Is it wrong for a Christian to masturbate? This really bothers me, since I feel that our physical lives should be something we share together, not separately.

First, not all husbands want intercourse more frequently than their wives. Generally, half the couples who seek sexual therapy because of lessened desire report that it is the husband who lacks desire. What differs is the reason men and women want intercourse. Surveys indicate that a man’s drive for sex is more often associated with desire for release while a woman desires physical intimacy, warmth and cuddling.

Your husband desires release more often than you do, and to get that release he sometimes masturbates. Many women report that their husband’s masturbation makes them feel guilty for not taking care of his needs. However, that “duty” approach to sex distorts what we believe the Bible teaches about the sexual relationship in marriage.

It is true, as 1 Corinthians 7:1-6 teaches, that our bodies are each other’s to enjoy and we are not to withhold sex from each other except by mutual agreement for a time set aside for prayer. But that is a mutual command for both spouses–not one for the wife to provide release for the husband. That concept of mutuality underlies every New Testament passage that teaches about the sexual relationship in marriage. So if one spouse desires sex more than the other, we don’t withhold ourselves, nor do we expect to engage in an activity that would not be desirable for the other. We both look on the other’s needs as more important than our own (Phil. 2:3).

The primary question you are asking, however, is whether self-stimulation is an appropriate way for your husband to take care of his needs when the two of you are not available to each other for intercourse. The Bible offers no direct teaching on masturbation. Most teaching has been based on the story of Onan, the son of Judah, who was obligated to produce an offspring for his deceased brother’s wife. But “Onan knew that the offspring would not be his, so it came about that when he came to his brother’s wife, he wasted his seed on the ground, in order not to give off-spring to his brother” (Gen. 38:9). Onan’s behavior displeased God, but the displeasing behavior was that Onan refused to provide offspring as God had commanded. Similar passages have been construed to teach that masturbation is condemned by Scripture, but all of those are dependent on the reader’s interpretation. There is no direct teaching against or for masturbation.

When the Bible offers no direct teaching on a subject, we must apply other biblical principles to help us prayerfully discern God’s will for us. So, on the subject of masturbation, a couple should answer these questions:

First, is the self-stimulation harmful to your mutual expectation to be available to one another sexually? If one spouse masturbates instead of being available to the other, then he or she is violating the relationship.

Second, is the masturbation associated with lust? Lust is the desire to have something or someone that is not ours. Self-stimulation often becomes connected with a desire for a person who is not your spouse or for a certain body type that is different from your spouse’s, and that is absolutely wrong. It is possible for self-stimulation to be a mere physical response to a sexual urge without any thought of anyone or for the activity to be accompanied by images of being with one’s spouse. In those situations, there is no lust associated with self-stimulation.

Third, has masturbation become an addiction or enslavement? If a person is controlled by masturbation he is enslaved by or addicted to it. Many behaviors become sin when they enslave a person. In 1 Corinthians 6:12, Paul says, “‘Everything is permissible for me,’ but I will not be mastered by anything” (see also 1 Cor. 10:23-31).

Fourth, does the masturbation involve self-abuse? Occasionally, people who have been abused in the past may abuse themselves physically or emotionally when they masturbate. This is always wrong. Our bodies are the temple of the Holy Spirit and should be cared for and protected.

We should not be possessed, mastered or enslaved by our sexual drive. Nevertheless, the sexual drive that is in us is a natural, God-given drive. Keeping these two facts in balance will help you and your husband decide how to think about masturbation in your marriage.

When Children Stimulate Genitals Excessively

From a counselor: I have a perplexing client case involving a 7 year old girl who masturbates several times a day, including during school. The school has required therapy for the girl. I can not verify any sexual abuse, although she witnessed her parents in multiple domestic violence situations. I would appreciate any help I can get.

Our book Sex Facts for the Family may offer some help. Our basic approach would be to treat her as if she has been sexually abused, whether that was direct abuse or the indirect trauma of her parents’ domestic violence. We would also wonder if she experienced physical abuse or severe spanking and masturbation became her way of self soothing. We find that the primary need for continuing with excessive masturbation is need for physical affirmation. It would be interesting to see what would happen if the following program were implemented:

Continue to treat her for her emotional wounds = therapy

At least triple the amount of physical nurturing = holding and reading to, hugs, back rubs at bedtime, holding her hand to fall asleep, etc.

Distract from masturbation, by offering one of the above whenever she is seen “stroking herself”

Give her a function in the classroom to keep her hands busy at the times she is most likely to masturbate.

In other words: deal with the emotional issues leading to the behavior, substitute the self-soothing with adult nurturing, and distract for what is by now a compulsive habit.

Sexual Activity during Menstruation

I am wondering if there is a baseline or typical level or type of sexual activity that healthy Christian couples engage in while the wife is having her period. I can imagine there would be a range between absolutely nothing on one end and manual or other kinds of stimulation on the other. If your experience has given you a sense of what the “normal” range is, I would like to hear it.

There are no restrictions for what you can do sexually during a woman’s period; it is a matter of personal preference. As you suggested, some couples refrain completely; for others, it doesn’t change their activity at all. It is best to discuss it as a husband and wife and respect the spouse who is the most cautious/hesitant/conservative, so that no spouse is violated in the process. All sexual activity is to be for the mutual enjoyment of the couple and for the connection, growth and enhancement of the marital relationship.

Diminished Sexual Excitement

My husband and I got physically involved when we were dating. Although we didn’t have sex, we did frequently reach a point where we felt very sexually aroused. Now that we’re married and are free to enjoy each other, I find that the level of excitement is much lower for me. We try to go slow and take our time, like we did when we were dating, but I still don’t feel as passionate as I did before we were married. What is going on?

There are several reasons why passion dips after marriage. First, many of us associate sexual feelings with sin rather than affirm God’s beautiful design of our sexuality as part of his perfect plan. We are sexual beings; our sexuality, our sexual feelings and our sexual urges are from God, and they’re good. Sexual responsesand feelings will happen and do occur even while we sleep. Men have erections every 80 to 90 minutes while they sleep and women lubricate vaginally (get aroused) every 80 to 90 minutes while they sleep. However, our sexual behaviors are ourresponsibility. We can choose to abstain from sex until we’re married; and we are the ones who make great sex happen in our marriages.

If your sexual feelings were associated with guilt in your premarital activity, there will have been an adrenaline rush that occurred with the sexual arousal. This guilt/adrenaline connection heightened the feelings of the intensity of arousal. But that is not the type of arousal we tend to experience in marriage. Married sex, as God designed it, is deeply satisfying for both partners and is combined with fun, pleasure and the free enjoyment of each other’s bodies. Married sex is not likely to grab you with an intense adrenaline rush that sweeps you off your feet. Unfortunately, many couples who grew up watching the guilt/adrenaline rush on television and in movies find it hard to shake that expectation and make the shift to the warm, fulfilling sexual relationship of marriage.

So relax your expectation for that adrenaline rush of excitement. Instead, focus your energies on building intimacy, pleasure, fun and fulfillment. Make time for your sexual relationship rather than waiting for the passionate feeling, and your sexual relationship will grow to be a vital and meaningful part of your shared life as a couple.

Second, hormonal changes due to oral contraceptive can affect sexual intensity. Talk to your physician and ask if there is a birth control pill higher in androgen and lower in progestin activity than the one you are taking (if you are on a pill).

Third, women who were sexually abused learned to associate sex with something wrong rather than right, and shut down shortly before, at, or soon after marriage. If you have any suspicion that you could be reacting to past sexual trauma, seek professional help.

Husband with a Low Libido

My husband and I are newlyweds, but we only have sex about three times a month. He just says he is unwilling to become more affectionate toward me. Sometimes when I bring up the subject, he pushes me away or gets sarcastic. Am I doing something wrong?

Eventually, you might need to see a counselor, but you can start with self-help. Begin by sorting out with your husband the source of his resistance to sexual intimacy. Ask him if you are doing something wrong. It will be important for him to feel that you genuinely care for him as you attempt to understand what is causing him to avoid sex. Review the following reasons men are resistant to sex.

Childhood experiences. Men who were raised without intimacy (especially the lack of bonding during the first years of life) end up resisting sex. They have sexual drive but no capacity for closeness and warmth with a woman. The sexual retraining process of gradually learning to give and receive pleasure can help a man gain the capacity and desire for intimacy. However, he has to be willing. The decision to pursue sexual closeness may require the help of a therapist.

Sexual addiction. If your husband is uncomfortable with intimacy, he is probably finding sexual release through self-stimulation. A sexual addiction may lead him to get sexual release by looking at pornography or engaging in some other sexual preoccupation. If so, he probably feels conflict and guilt about his secret life. Your sexual approaches then only irritate him because they remind him of his sexually destructive behavior. If addiction is the problem, you will get the most help from one of the 12-step programs.

Personal issues. Some men avoid sex because of a personal issue, such as their wives’ bad breath or an aversion to vaginal secretions. If that is the case, your husband may not feel comfortable telling you. You will need to free him to express whatever he is feeling, even if it hurts you. A personal issue can usually be resolved by changing the habit.

Sexual inexperience. Your husband might feel sexually inept. The good news is that a sexually inexperienced male responds quickly and positively to education about sex and to sexual retraining. If you feel competent, teach him by talking him through a sexual experience as you would enjoy it. If not, the two of you wouldbenefit from reading aloud together and following the sexual retraining program in our book Restoring the Pleasure.

Past influences. Perhaps your husband grew up with a dominant, controlling mother who depreciated men; or he might have received rigid anti-sexual teaching as a boy. If he came to marriage with deeper emotional sexual blocks caused by destructive influences such as these, you should see a counselor.

Feeling crowded. If your husband senses neediness from you instead of sexual desire, his sarcasm and pushing away may be a reaction to your approach. A turned-on woman is a turn-on for a man, but a needy woman is a turn-off. If this is the sourceof the problem, get help with understanding the gap in your life that you are trying to fill with sex. In addition, allow your husband to initiate all sexual experiences and work on ways to connect with him non-sexually to fulfill your longing to feel desired.

Overwork. If your husband puts all his energy into his career, he may have no energy left for you. This is clearly an issue of priorities. You will have to schedule time for just the two of you–even if you become an appointment on his crowded calendar.

As you can see, the solution you pursue will depend on the source of your husband’s resistance to sex. If the steps you take don’t achieve the results you desire, find a counselor who specializes in treating sexual problems. You can’t make your husband want you; you can only address the issues that interfere with his desire for you.

Difficulty Getting an Erection

I’ve never had a problem, sexually speaking, until recently. Now, all of a sudden, I seem to be having difficulty getting an erection. I really do love my wife. In fact, she’s probably more attractive today than she was 23 years ago when we first got married. So what’s wrong with me?

Getting an erection is an involuntary response controlled by the relaxed branch (parasympathetic) of our involuntary nervous system. So when a man is relaxed and soaking in pleasure, he is likely to get an erection. However, anxiety or physical factors can interfere with this natural bodily response.

We would recommend first that you pursue a tumescence evaluation by a urologist who is a specialist in erectile dysfunction. Acardiac and vascular workup would also be indicated since an erection is a vascular response. You need to be sure that diabetes and certain medications can be ruled out as a possible cause of your difficulty.

If medical causes are eliminated, you should consider the emotional reasons for having difficulty getting an erection. First, men of all ages experience erectile difficulty at some time or another. The occasional inability to get or maintain an erection need not be an issue of concern. However, once anxiety and preoccupation with getting an erection has occurred, it tends to perpetuate itself. But the good news is that erectile responsiveness can be regained. Here’s how to do it:

First, you need to be distracted from the anxiety about getting an erection. To do that you need to temporarily rule out sexual intercourse, all attempts at having intercourse, and any demand or expectation of an erection during your times of lovemaking.

Second, you need to focus on pleasure and enjoying each other’s body, rather than concentrating on having sex. If you came to our office for counseling, we would take you through the teaching, talking and touching exercises of our sexual retraining process in Restoring the Pleasure.

As part of the process, we suggest that spouses give names to each other’s genitals and then make a habit of regularly touching each other’s genitals in an affirming manner. (Remember, sexual intercourse is not the goal here.) If preoccupation or concern about the state of your penis enters in at any time, you should tellyour wife. Verbalizing your anxiety interrupts the control your concern has over your penis.

Third, it’s important that your wife be freed to really enjoy your body for her pleasure. The more freely she can lose herself in the pleasure, the more likely it is that your natural response of erection will occur. In contrast, if she is concentrating on how your penis is doing, her evaluation will increase the performance demand on you and will likely decrease your erectile response. If following these guidelines does not solve your difficulty, you may want to consult with a sexual therapist.

With the availability of Viagra, you may wish to pursue getting a prescription. Viagra can be used to regain confidence when anxiety is the issue or to counteract physical interference with erectile response.

PMS Interrupting Sex Life

For two weeks every month I’m on an emotional roller coaster due to premenstrual syndrome (PMS), and it has done real damage to our sex life. My husband is reluctant to suggest that we have sex because he’s afraid I’ll shoot him down. Since he doesn’t have a similar hormonal civil war going on in his body, he doesn’t understand what I’m facing. What should I do about this?

PMS is real! It affects the quality of life for millions of women, yet too many couples do not realize there are ways to battle this problem.

Next, keep a log of the dates you experience certain symptoms. On your monthly chart, mark your symptoms with a number from 0 to 10, indicating the severity of the symptom on a given day.

These charts will enable you to predict the onset of your internal warfare and plan ahead for its effects. Plan positive sexual times for you and your husband for the two weeks leading up to your symptoms. Then, depending on the severity of your PMS, plan for the type of sexual encounter that would meet your needs and help relieve your stress during that difficult time. For example, you might enjoy being caressed everywhere except your breasts and genitals. Or you may not want to be touched anywhere, but would enjoy caressing your husband.

During those difficult two weeks, make time in your schedule for extra rest. Schedule a “walk-and-talk” time together to occur before your sexual time. Begin your actual physical time with a relaxing bubble bath or a warm shower. Planning for your PMS will reduce the damage to your sex life and increase your husband’s understanding.

It might also be possible to treat your PMS. Nutritionists and medical researchers recommend avoiding fat, sodium, alcohol and caffeine, increasing fresh fruits and vegetables, legumes and whole grains, and drinking eight to ten glasses of water a day. Some nutritionists recommend avoiding red meats and dairy products and including a daily intake of safflower oil and Evening Primrose Oil (a nutritional supplement).

In addition, aerobic exercise is a must. Exercise is thought to stimulate the release of ankephatins and endorphins–neurotransmitters responsible for a person’s sense of well-being. They need to be elevated in women who have PMS, so work up a good sweat with at least a half hour of jogging, swimming or some other aerobic exercise.

As the medical world begins to identify possible causes of PMS, treatments are becoming more effective. Some doctors encourage taking a vitamin-mineral supplement that after a month or two, relieves mild to moderate symptoms in many women. Consult with your physician or nutritionist for a recommendation. Two supplements that we have found to be effective are Optivite and Theraids-PMS; one of these may work for you.

If these measures don’t relieve your symptoms enough to boost your sexual relationship, seek further medical help. Prozac or anti-anxiety medications like Xanax, as well as natural progesterone suppositories, have been helpful in reducing some PMS symptoms. And because some severe cases of PMS have been linked with a bacterial infection, treatment with antibiotics can be effective. Keep seeking treatment until you get relief so you and your husband can enjoy sex for the entire month.

Painful Intercourse

My husband and I have been married six years and have a good sex life. But I always experience pain at the moment of penetration. We take things slowly, and after the initial pain things go well. But what can I do about that early discomfort?

God intended sex in marriage to bring pleasure. When that pleasure is interrupted because of pain, the entire process of “becoming one” is affected.

Unfortunately, pain is often difficult to relieve because the reason for it can’t be identified. To help you and your doctor determine why you are having discomfort, for the next four or five times you have intercourse, write down a description of the pain. Describe exactly when you feel the pain begin and when it lessens, the exact location of the pain, and the type of pain (stinging, burning, jabbing or a feeling of pressure).

It’s also helpful to write down information from a genital self-examination. In a comfortable position, using a vaginal lubricant and holding a mirror, examine the opening of your vagina for redness, irritation, rash or sores. Is there tightness or pain when you insert a finger? Note any sensations you feel when tightening or relaxing your vaginal muscle around your finger or when pressing your finger against your vaginal wall. Using a Q-tip, tap around the opening of your vagina. Note any particular spot that elicits pain when tapped. Write down what you discover.

Once you have written data, schedule an appointment with your physician. If he or she still can’t help, try to locate a medical doctor who is both a gynecologist and a urologist who specializes in treating painful intercourse (dyspareunia). A resource for locating such a specialist can be obtained by calling and joining the Vulvar Pain foundation at 336-226-0704. You may also contact them on the Web at www.vulvarpainfoundation.org. Inflammation or irritation of any of the structures of the genital area will cause pain and will require medical attention. Chronic infections such as genital warts or herpes also can cause pain upon entry.

As sexual therapists, we treat a common cause of painful intercourse called vaginismus, the involuntary spastic tightening of the muscle controlling the entrance to the vagina. To relieve vaginismus, the woman uses a series of graduated dilators to stretch and relax the muscles that control the opening of the vagina. She begins by daily inserting the smallest dilator that she can comfortably insert, using the same process as recommended for vaginal self-examination. She leaves the dilator in place for 15 to 30 minutes while tightening and relaxing the vaginal muscle. When she feels ready, she tries the next larger dilator. She continues to graduate to larger dilators until she is able to comfortably insert a dilator of the same or larger circumference as the head of her husband’s erect penis. You are fortunate to have a good sex life in spite of your initial discomfort. But you need to pursue a solution that will enable you to have entry without any pain.

Plagued by Premature Ejaculation

This is probably a typical early-married question, but I’ll ask it anyway: How does a guy control ejaculation?

The single most common problem men report is premature ejaculation –not having control of when ejaculation occurs or ejaculating before he and his wife are ready for him to respond.

The seriousness of the problem varies. A man may have so little control that he ejaculates before entry or when his wife touches his penis. More commonly, the man is unable to last more than a minute or two after entry.

Ejaculating quickly seems to be a learned reflex response that can be effectively reconditioned when a husband and wife actively pursue learning ejaculation control together. There are four basic principles and guidelines for learning to control ejaculation.

First, the husband needs to shift his focus away from ejaculation onto pleasure. He needs to savor the sensations of touch and arousal rather than being anxious about or eager for release.

Second, the man must allow himself to be passive and “soak in” pleasure rather than actively pursuing arousal and release. Ejaculation is controlled by the active branch of the involuntary nervous system, so passivity helps delay that automatic active response.

Third, the man needs to increase his awareness of the sensations of arousal building so that he can identify, on a scale of zero (no arousal) to ten (orgasm), the level of his arousal.

Fourth, awareness of sensations of arousal and ejaculatory control can be learned by a following a step-by-step process. We teach couples the use of the squeeze technique, as adapted from Masters and Johnson. Helen Singer Kaplan teaches the stop-start technique, which is basically the same as the squeeze, except instead of applying the squeeze, all genital stimulation is stopped. To learn this process, be very deliberate in mastering each step we have detailed in Restoring the Pleasure. To prevent failure, be sure the squeeze is applied or the stimulation is stopped as soon as the husband reaches full erection rather than waiting until he is approaching ejaculation (i.e., when he is identifying his arousal in the lower numbers of 3 to 6 rather than when he is approaching level 10). Take a break by moving away from genital touching and pursue general body caressing. The man’s thoughts and focus must move with the touch. With careful attention to the step-by-step process, pleasure can be enhanced as control is learned.

Haunted by Childhood Sexual Abuse

Before we were married, we could hardly wait to be together. But no sooner had the honeymoon ended then our sex life began to cool. By our sixth-month anniversary, it was as if a wall would go up between us every time I even mentioned to my wife the possibility of making love. Needless to say, I’m feeling frustrated–not to mention rejected. What is happening to us?

The drop in sexual desire so early in a marriage, accompanied by an aversion to specific sexual activities, is usually indicative of past sexual abuse. For a woman who was so abused, her sexuality has been aroused prematurely, and it has been associated with shame, demand, immobilization and lack of power. Therefore, as an adult before marriage, when sex is not expected (no demand) or when she can choose how far to go (not immobilized), sex may be pursued to get love and feel power over her sexuality. Once the commitment of marriage occurs, however, sex becomes expected (demand), the feeling of lack of choice and immobilization during sex sets in quickly. She resumes the feelings and flashbacks of the abused and used victim. Consequently, her resistance to you is her protection against repeating what her emotions perceive as victimization.

This association between her childhood sexual abuse and post-marital sex can change, but professional help is usually necessary. Being part of a support group of other women who were sexually abused is most important. Your wife will need to talk about what happened to her as a child. She will have to relive those painful details and grieve the losses she experienced during those acts of violation. Keeping a journal of any memories, thoughts, feelings or flashbacks will help relieve the power that the past has on her current married sexual life.

When the two of you are ready and willing to rebuild your sexual life together, first, it will be important for you to allow her to be the active and dominant partner sexually, so that sex is not something “done to her,” but something she chooses to do.

Second, it will be important for the two of you to discuss the specific violations that happened to her and avoid those behaviors as much as possible.

Third, she will need to let you know when–during your sexual times–she has flashbacks of past abuse. At that time, stop what you are doing–just hold and affirm her.

Female Ejaculation

My problem is that I almost always (with a very rare exception) urinate either during an orgasm or right before. I’m not sure if I have ever really reached the height of an orgasm. I have to make my husband stop stimulating me and once I have urinated, I”m not able to reach another orgasm. Is this normal? I have read a few books on the subject of sex and have never seen this situation described. Can you help me?

Thank you for your letter which shares your struggle so openly. It may come as a surprise to you, but many women experience a release of fluid with orgasm. It is our estimate that about 5% of women experience this response- most of them silently. We think of it as a normal variation in women’s responses. It is referred to as female ejaculation. We understand that it feels like urination, but in fact, if you were to have the fluid analyzed by a lab, you would discover that it has a different chemical composition than urine. We write about this in our book Restoring the Pleasure (pp. 80, 117, 249).

This flooding response is typically reported by women who are intensely sexual and is most commonly a result of vaginal or G-spot stimulation. It should be celebrated and enjoyed as part of your orgasm. If you try to stop it, you will only end up frustrated. So we recommend that you prepare the bed with an extra towel or two and “go for it!” If you can be aggressive in going for it, it will heighten your pleasure. To read more about this in detail, see The G-Spot by Laddas, Whipple and Perry. Hope this helps!

Penis Size

Please forgive this unsolicited inquiry, but I just don’t know where else to turn. I have purchased your excellent book, “The Gift of Sex” and recommend it to couples I counsel. I have a sensitive question that I do not feel comfortable asking anyone who knows me. It has to do with feelings of inadequacy on my part of not “measuring up” due to the particular way my sexual anatomy is set up. Although my penis works fine, rightly and or wrongly, I feel the extreme smallness of my penis is an incredible obstacle for me to overcome (emotionally), although my wife is lovingly accepting of me (I am thankful for this for sure).

Where can I obtain a straight answer from a Christian resource on whether or not it is possible to increase the size of my penis? Is there an herbal product, growth hormone, safe steroid, exercise or procedure that I can purchase to safely alter the size of my penis?

I have tried to use the Internet to do some research but as you can imagine, I find it difficult if almost impossible to safely surf the Internet with integrity on this subject without encountering pornographic entrepreneurs. I want to avoid pornography at all costs.

I am so embarrassed to write this email but I just want to know from an expert if this is a situation where there is hope and help or I just need to resign myself to accepting the equipment “as is” as God has fashioned me.

You are not alone in your concern. Many men struggle with issues regarding penis size. Although there are no proven methods to increasing the size of any body parts, there would be nothing wrong with a three month or so trial of those solutions so frequently advertised on the Internet. The only concern would be any medical side affects, which would be best checked out with your physician, yet from your message, it is unlikely that you will be comfortable bringing this to him. We may be able to refer you to a medical doctor in a larger city nearby who specializes in male sexual issues.

To avoid the pornographic temptation, you might have your wife do the Internet research for you or with you. There are some steps you can try. First, there is a supplement (vitamin) that we have checked out thoroughly and highly recommend for all men to enhance genital and reproductive health. It is Prostrate Support Formula 600 for Men by Natures Life. Take two a day. You are likely to find it at a health food store. There are other similar products by other companies, but this is the one we have researched.

What we would also recommend is that you actually measure your penis with a cloth tape measure when it is fully erect. Measure length and circumference at the fullest ridge. We have a chart of the range of penis sizes so we could give feedback to you where you actually are on that chart. That information would also give you a baseline to make some before and after comparisons if you should start taking the supplement and/or try any other enhancement possibilities.

Our conviction and teaching is that penis size does not matter at all. It is only in the lower 1 1/2″ to 2″ of the vagina that the women receives pleasure and the vaginal opening (that 1 1/2″ to 2″) is controlled by a group of muscles so it can tighten or stretch as much as is needed to accommodate any size penis. Yet we know that you are not alone in your concern and your feelings may not be relieved by this information.

Headache During Sex

My husband gets massive headaches when he orgasms. Is this something to be concerned about?

Although headaches with orgasm are not usually a serious medical issue, your husband needs to have his condition checked out by his physician. Typically a CT (computed topography) scan will be done to rule out any serious problem. The medical term, “Coital or Orgasmic Cephalgia”, refers to a headache that begins to build as the man is moving toward orgasm or to a sudden, explosive headache that occurs at the point of orgasm. The headache may come sporadically or regularly for a period of time and then may disappear on its own. Medication can be taken two hours before sex to avoid the headaches. They can be extremely painful. Be sure your husband sees his medical doctor soon.

Sex in the Later Years

What kind of changes in our physical relationship can my husband and I expect as we get older? We’re currently in our thirties and have sex an average of two to three times a week. Will that frequency change? Does passion lessen? What can we do now to ensure that our sex lives will always be fun and fulfilling?

Procreation may be for the young, but sexual pleasure is for both the young and old. God designed us as sexual beings from the moment of birth until the moment of death. Our sexuality does not die until we die.

Yes, there are some changes as we age that will affect sexual functioning. For most women, estrogen and progesterone levels drop in their fifties (sometimes as early as their thirties or as late as their sixties); and with that drop, women stop menstruating and reach menopause. Some women also experience a drop in the sexual energy hormone, testosterone. Unless a woman undergoes hormonal replacement therapy, she is likely at this time to have vaginal dryness, some irritation, and possibly a lessening of sexual desire and response. Having a complete hormonal evaluation, using a vaginal lubricant, exercising the P.C. muscle, and keeping active sexually are ways to counteract the changes of aging.

For men, the male hormone testosterone begins to decrease at age 40 and decreases significantly from age 60 on. These changes need not affect the frequency or pleasure of the sexual experience, however, hormonal and cardiovascular changes can be the bases for sexual dysfunction, so should be evaluated by a urological sexual specialist. There are five changes that men experience as they age:

1. A man will require direct penile stimulation to get an erection, rather than responding to visual stimuli or thought stimulus. This may actually enhance lovemaking for the older couple, because the man and the woman will become more similar in their arousal response pattern.

2. A man’s erections may not be as firm as they were when he was younger. He still will be able to enter and have total fulfillment unless he becomes anxious about his decrease in firmness. Impotence is not the result of the aging process, it is a result of either anxiety about the aging process or other physiological changes that are due to disease or medication.

3. The man’s ejaculations become less intense as he ages. Yet the experience is equally satisfying.

4. A man may not need to ejaculate with each sexual experience. He may feel totally satisfied without an ejaculation.

5. A man will need a longer rest period between erection and ejaculation until he can be restimulated to another erection.

All of these changes need to be recognized and adjusted for, but they need not lead to a decrease in frequency or passion. We would recommend that you keep your sexual relationship alive as you progress through the next stages of life. Make certain your time together is a priority, that you both are mutually satisfied, that you keep reading and talking about your sexual relationship, that you bring something new to your sexual experience every now and then, and that you seek medical evaluation from an expert in sexual functioning if your usual pattern of response changes in a way that concerns you. By doing these things, you will find new joy as you continue the pleasure of your marital bed–even into your old age.